Qualitative data

Qualitative data come in various forms. In many qualitative nursing studies, the
database consists of interview transcripts from open ended, focused, but exploratory
interviews. However, there is no limit to what might possibly constitute a qualitative
database, and increasingly we are seeing more and more creative use of such sources as
recorded observations (both video and participatory), focus groups, texts and documents,
multi-media or public domain sources, policy manuals, photographs, and lay
autobiographical accounts.

Qualitative data are not the exclusive domain of qualitative research. Rather, the term
can refer to anything that is not quantitative, or rendered into numerical form. Many
quantitative studies include open ended survey questions, semistructured interviews, or
other forms of qualitative data. What distinguishes the data in a quantitative study from
those generated in a qualitatively designed study is a set of assumptions, principles, and
even values about truth and reality. Quantitative researchers accept that the goal of
science is to discover the truths that exist in the world and to use the scientific method
as a way to build a more complete understanding of reality. Although some qualitative
researchers operate from a similar philosophical position, most recognise that the
relevant reality as far as human experience is concerned is that which takes place in
subjective experience, in social context, and in historical time. Thus, qualitative
researchers are often more concerned about uncovering knowledge about how people
think and feel about the circumstances in which they find themselves than they are in
making judgements about whether those thoughts and feelings are valid.

Qualitative analytic reasoning processes

What makes a study qualitative is that it usually relies on inductive reasoning processes
to interpret and structure the meanings that can be derived from data. Distinguishing
inductive from deductive inquiry processes is an important step in identifying what
counts as qualitative research. Generally, inductive reasoning uses the data to generate
ideas (hypothesis generating), whereas deductive reasoning begins with the idea and
uses the data to confirm or negate the idea (hypothesis testing).2 In actual practice,
however, many quantitative studies involve much inductive reasoning, whereas good
qualitative analysis often requires access to a full range of strategies.3 A traditional
quantitative study in the health sciences typically begins with a theoretical grounding,
takes direction from hypotheses or explicit study questions, and uses a predetermined
(and auditable) set of steps to confirm or refute the hypothesis. It does this to add
evidence to the development of specific, causal, and theoretical explanations of
phenomena.3 In contrast, qualitative research often takes the position that an interpretive
understanding is only possible by way of uncovering or deconstructing the meanings of
a phenomenon. Thus, a distinction between explaining how something operates
(explanation) and why it operates in the manner that it does (interpretation) may be a
more effective way to distinguish quantitative from qualitative analytic processes
involved in any particular study.

Because data collection and analysis processes tend to be concurrent, with new analytic
steps informing the process of additional data collection and new data informing the
analytic processes, it is important to recognise that qualitative data analysis processes
are not entirely distinguishable from the actual data. The theoretical lens from which the
researcher approaches the phenomenon, the strategies that the researcher uses to collect
or construct data, and the understandings that the researcher has about what might count
as relevant or important data in answering the research question are all analytic
processes that influence the data. Analysis also occurs as an explicit step in
conceptually interpreting the data set as a whole, using specific analytic strategies to
transform the raw data into a new and coherent depiction of the thing being studied.
Although there are many qualitative data analysis computer programs available on the
market today, these are essentially aids to sorting and organising sets of qualitative data,
and none are capable of the intellectual and conceptualising processes required to
transform data into meaningful findings.

Specific analytic strategies

Although a description of the actual procedural details and nuances of every qualitative
data analysis strategy is well beyond the scope of a short paper, a general appreciation
of the theoretical assumptions underlying some of the more common approaches can be
helpful in understanding what a researcher is trying to say about how data were sorted,
organised, conceptualised, refined, and interpreted.

CONSTANT COMPARATIVE ANALYSIS

Many qualitative analytic strategies rely on a general approach called “constant

comparative analysis”. Originally developed for use in the grounded theory
methodology of Glaser and Strauss,4 which itself evolved out of the sociological theory
of symbolic interactionism, this strategy involves taking one piece of data (one
interview, one statement, one theme) and comparing it with all others that may be
similar or different in order to develop conceptualisations of the possible relations
between various pieces of data. For example, by comparing the accounts of 2 different
people who had a similar experience, a researcher might pose analytical questions like:
why is this different from that? and how are these 2 related? In many qualitative studies
whose purpose it is to generate knowledge about common patterns and themes within
human experience, this process continues with the comparison of each new interview or
account until all have been compared with each other. A good example of this process is
reported in a grounded theory study of how adults with brain injury cope with the social
attitudes they face (see Evidence-Based Nursing, April 1999, p64).

Constant comparison analysis is well suited to grounded theory because this design is
specifically used to study those human phenomena for which the researcher assumes
that fundamental social processes explain something of human behaviour and
experience, such as stages of grieving or processes of recovery. However, many other
methodologies draw from this analytical strategy to create knowledge that is more
generally descriptive or interpretive, such as coping with cancer, or living with illness.
Naturalistic inquiry, thematic analysis, and interpretive description are methods that
depend on constant comparative analysis processes to develop ways of understanding
human phenomena within the context in which they are experienced.

PHENOMENOLOGICAL APPROACHES

Constant comparative analysis is not the only approach in qualitative research. Some
qualitative methods are not oriented toward finding patterns and commonalities within
human experience, but instead seek to discover some of the underlying structure or
essence of that experience through the intensive study of individual cases. For example,
rather than explain the stages and transitions within grieving that are common to people
in various circumstances, a phenomenological study might attempt to uncover and
describe the essential nature of grieving and represent it in such a manner that a person
who had not grieved might begin to appreciate the phenomenon. The analytic methods
that would be employed in these studies explicitly avoid cross comparisons and instead
orient the researcher toward the depth and detail that can be appreciated only through an
exhaustive, systematic, and reflective study of experiences as they are lived.

Although constant comparative methods might well permit the analyst to use some
pre-existing or emergent theory against which to test all new pieces of data that are
collected, these more phenomenological approaches typically challenge the researcher
to set aside or “bracket” all such preconceptions so that they can work inductively with
the data to generate entirely new descriptions and conceptualisations. There are
numerous forms of phenomenological research; however, many of the most popular
approaches used by nurses derive from the philosophical work of Husserl on modes of
awareness (epistemology) and the hermeneutic tradition of Heidegger, which
emphasises modes of being (ontology).5 These approaches differ from one another in the
degree to which interpretation is acceptable, but both represent strategies for immersing
oneself in data, engaging with data reflectively, and generating a rich description that
will enlighten a reader as to the deeper essential structures underlying a particular
human experience. Examples of the kinds of human experience that are amenable to this
type of inquiry are the suffering experienced by individuals who have a drinking
problem (see Evidence-Based Nursing, October 1998, p134) and the emotional
experiences of parents of terminally ill adolescents (see Evidence-Based Nursing,
October 1999, p132). Sometimes authors explain their approaches not by the
phenomenological position they have adopted, but by naming the theorist whose
specific techniques they are borrowing. Colaizzi and Giorgi are phenomenologists who
have rendered the phenomenological attitude into a set of manageable steps and
processes for working with such data and have therefore become popular reference
sources among phenomenological nurse researchers.

ethnographic methods
Ethnographic research methods derive from anthropology's tradition of interpreting the
processes and products of cultural behaviour. Ethnographers documented such aspects
of human experience as beliefs, kinship patterns and ways of living. In the healthcare
field, nurses and others have used ethnographic methods to uncover and record
variations in how different social and cultural groups understand and enact health and
illness. An example of this kind of study is an investigation of how older adults adjust to
living in a nursing home environment (see Evidence-Based Nursing, October 1999,
p136). When a researcher claims to have used ethnographic methods, we can assume
that he or she has come to know a culture or group through immersion and engagement
in fieldwork or participant observation and has also undertaken to portray that culture
through text.6 Ethnographic analysis uses an iterative process in which cultural ideas
that arise during active involvement “in the field” are transformed, translated, or
represented in a written document. It involves sifting and sorting through pieces of data
to detect and interpret thematic categorisations, search for inconsistencies and
contradictions, and generate conclusions about what is happening and why.

NARRATIVE ANALYSIS AND DISCOURSE ANALYSIS

Many qualitative nurse researchers have discovered the extent to which human
experience is shaped, transformed, and understood through linguistic representation.
The vague and subjective sensations that characterise cognitively unstructured life
experiences take on meaning and order when we try to articulate them in
communication. Putting experience into words, whether we do this verbally, in writing,
or in thought, transforms the actual experience into a communicable representation of it.
Thus, speech forms are not the experiences themselves, but a socially and culturally
constructed device for creating shared understandings about them. Narrative analysis is
a strategy that recognises the extent to which the stories we tell provide insights about
our lived experiences.7 For example, it was used as a strategy to learn more about the
experiences of women who discover that they have a breast lump (see Evidence-Based
Nursing, July 1999, p93). Through analytic processes that help us detect the main
narrative themes within the accounts people give about their lives, we discover how
they understand and make sense of their lives.

By contrast, discourse analysis recognises speech not as a direct representation of

human experience, but as an explicit linguistic tool constructed and shaped by numerous
social or ideological influences. Discourse analysis strategies draw heavily upon
theories developed in such fields as sociolinguistics and cognitive psychology to try to
understand what is represented by the various ways in which people communicate ideas.
They capitalise on critical inquiry into the language that is used and the way that it is
used to uncover the societal influences underlying our behaviours and thoughts.8 Thus,
although discourse analysis and narrative analysis both rely heavily on speech as the
most relevant data form, their reasons for analysing speech differ. The table⇓ illustrates
the distinctions among the analytic strategies described above using breast cancer
research as an example.

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General distinctions between selected qualitative research approaches: an illustration

using breast cancer research

Cognitive processes inherent in qualitative analysis

The term “qualitative research” encompasses a wide range of philosophical positions,
methodological strategies, and analytical procedures. Morse1 has summarised the
cognitive processes involved in qualitative research in a way that can help us to better
understand how the researcher's cognitive processes interact with qualitative data to
bring about findings and generate new knowledge. Morse believes that all qualitative
analysis, regardless of the specific approach, involves:

 comprehending the phenomenon under study

 synthesising a portrait of the phenomenon that accounts for relations and linkages
within its aspects

 theorising about how and why these relations appear as they do, and

 recontextualising, or putting the new knowledge about phenomena and relations

back into the context of how others have articulated the evolving knowledge.

Although the form that each of these steps will take may vary according to such factors
as the research question, the researcher's orientation to the inquiry, or the setting and
context of the study, this set of steps helps to depict a series of intellectual processes by
which data in their raw form are considered, examined, and reformulated to become a
research product.

Quality measures in qualitative analysis

It used to be a tradition among qualitative nurse researchers to claim that such issues as
reliability and validity were irrelevant to the qualitative enterprise. Instead, they might
say that the proof of the quality of the work rested entirely on the reader's acceptance or
rejection of the claims that were made. If the findings “rang true” to the intended
audience, then the qualitative study was considered successful. More recently, nurse
researchers have taken a lead among their colleagues in other disciplines in trying to
work out more formally how the quality of a piece of qualitative research might be
judged. Many of these researchers have concluded that systematic, rigorous, and
auditable analytical processes are among the most significant factors distinguishing
good from poor quality research.9 Researchers are therefore encouraged to articulate
their findings in such a manner that the logical processes by which they were developed
are accessible to a critical reader, the relation between the actual data and the
conclusions about data is explicit, and the claims made in relation to the data set are
rendered credible and believable. Through this short description of analytical
approaches, readers will be in a better position to critically evaluate individual
qualitative studies, and decide whether and when to apply the findings of such studies to
their nursing practice.

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